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The nurse is taking a history of a mother who admits to cocaine drug use. Which action should the nurse take first?
- A. Refer the patient to a drug abuse program.
- B. Screen the infant for side effects associated with cocaine use.
- C. Educate the patient of the risks associated with cocaine use during pregnancy.
- D. Advise the patient that her baby will be okay even with the history of cocaine use.
Correct Answer: C
Rationale: The correct action for the nurse to take first is to educate the patient of the risks associated with cocaine use during pregnancy (Choice C). This is important because it helps the mother understand the potential harm that cocaine can cause to both her and her baby. By providing education, the nurse can empower the mother to make informed decisions for the health and well-being of herself and her baby. Referring the patient to a drug abuse program (Choice A) may be necessary but not the immediate first step. Screening the infant for side effects (Choice B) should be done later after educating the mother. Advising the patient that her baby will be okay (Choice D) is not appropriate as it downplays the seriousness of cocaine use during pregnancy.
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A pregnant patient is 28 weeks gestation and reports feeling nauseated. What is the nurse's priority intervention?
- A. Encourage the patient to drink ginger tea to alleviate nausea.
- B. Recommend the patient eat larger meals to prevent nausea.
- C. Encourage the patient to eat smaller, more frequent meals.
- D. Instruct the patient to avoid all foods and drinks until the nausea resolves.
Correct Answer: C
Rationale: The correct answer is C: Encourage the patient to eat smaller, more frequent meals. This is the priority intervention because nausea during pregnancy, especially in the second trimester, is common and can be alleviated by eating smaller, more frequent meals to prevent fluctuations in blood sugar levels. Ginger tea (A) may help with nausea, but ensuring proper nutrition through small, frequent meals is the priority. Recommending larger meals (B) can worsen nausea due to increased stomach distention. Instructing the patient to avoid all foods and drinks (D) is not appropriate as it can lead to dehydration and nutrient deficiencies.
During a preconception counseling session, the nurse encourages a couple to prepare a birth plan.
- A. Promote communication between the couple and health care professionals.
- B. Enable the couple to learn about the types of pain medicine used in labor.
- C. Provide the couple with a list of items that they should take to the hospital for the labor and delivery.
- D. Give the high-risk couple a sense of control over the likelihood of having a surgical delivery.
Correct Answer: A
Rationale: A birth plan fosters open communication between the couple and healthcare providers, ensuring that expectations and preferences are understood.
A nurse is providing prenatal education to a pregnant patient who is at 30 weeks gestation. Which of the following symptoms should the nurse instruct the patient to report immediately?
- A. Mild back pain and cramping.
- B. Feeling of pelvic pressure after physical activity.
- C. Regular contractions every 10 minutes or less.
- D. Occasional headaches and fatigue.
Correct Answer: C
Rationale: The correct answer is C. Regular contractions every 10 minutes or less can indicate preterm labor, which is a serious concern at 30 weeks gestation. The nurse should instruct the patient to report this immediately for further evaluation to prevent premature delivery.
A: Mild back pain and cramping are common discomforts during pregnancy and may not be alarming at this stage.
B: Feeling of pelvic pressure after physical activity is also common during pregnancy and does not necessarily indicate an urgent issue.
D: Occasional headaches and fatigue are common symptoms in pregnancy and do not typically require immediate attention unless they are severe or persistent.
The nurse is assessing a pregnant patient at 28 weeks gestation who reports increased vaginal discharge. What is the nurse's priority action?
- A. Assess the characteristics of the discharge, including color and odor.
- B. Encourage the patient to rest and monitor for changes in discharge.
- C. Perform a pelvic exam to assess the discharge further.
- D. Call the healthcare provider immediately to report the change.
Correct Answer: A
Rationale: The correct answer is A: Assess the characteristics of the discharge, including color and odor. This is the priority action because it allows the nurse to gather important information to determine if the increased vaginal discharge is normal or if it may indicate an infection or other issue. By assessing the characteristics, such as color and odor, the nurse can make an informed decision on the next steps for the patient's care.
Choice B is incorrect because simply monitoring for changes without assessing the characteristics of the discharge may delay necessary interventions. Choice C is incorrect because performing a pelvic exam should not be the first action without first assessing the characteristics of the discharge. Choice D is incorrect because calling the healthcare provider immediately may not be necessary if the discharge is normal.
When preparing to teach a class about prenatal development, the nurse would include information about folic acid supplementation. What is folic acid known to prevent?
- A. Congenital heart defects
- B. Neural tube defects
- C. Mental retardation
- D. Premature birth
Correct Answer: B
Rationale: It is now known that folic acid supplements can prevent neural tube defects such as spina bifida.